I am fortunate that I have a home to return to at the end of the day, but too many Hawaii families, return to a shelter, a highway, or a park. Homelessness is one of the top priorities of our legislature and our residents, but despite our efforts, our homeless crisis still persists.
We cannot continue to make small changes. We need to think radical and big.
This is my plan to reduce homelessness:
Implement a Housing First model to address homelessness
Reform the way we do homeless sweeps
Increasing pay and hiring more qualified social workers
Invest in mobile clinics and public lockers.
Allow doctors to prescribe Medicaid for rent.
Improving the safety and cleanliness of our shelters.
Studies have shown that once you house an individual, their positive outcomes increase dramatically, and their negative impacts to society decrease. They get healthier, they are more likely to engage with social workers, their rates of substance abuse decrease, and their average Medicaid costs drop by 48% - 73%. This is why Hawaii needs to implement a housing first model to address homelessness.
Currently, the Department of Human Services has applied the Housing First model across the homeless continuum of care and has incorporated this approach into all state funded homeless program contracts. The goal cannot only be rapid re-housing, but emphasis must also be put on housing retention and the wrap around services that will enable people placed in permanent housing to remain housed. We need to implement more programs that focus on permanent, supportive housing.
Some key factors to a successful Housing First plan will be:
Section 8 Expansions
Affordable Housing Development
Hiring Additional Social Workers
The stated intention of homeless sweeps was to clear the sidewalks, not to bully the homeless. However, it has become clear that not only is the practice ineffective at permanently clearing out parks and sidewalks, it has also become a hindersom, punitive, and dehumanizing tactic that has eroded trust between the homeless population, law enforcement, and the general public. I don’t believe we should discontinue sweeps entirely, but I think we need to reform the way we do homeless sweeps.
Reform means making a concentrated effort to locate the owners of belongings so they don’t lose their personal effects, including essential documents they need for services and to apply for jobs. I believe that every homeless sweep should be accompanied by a minimum of four qualified social workers to assist the homeless during their move. These social workers should be responsible for helping them transition into a shelter with their belongings, and assisting them in obtaining any services they might need.
Of course, this means we need more social workers. I believe a small increment of all of our various tax revenues should go to increasing pay and hiring more qualified social workers.
Social workers tend to be overworked and overwhelmed; this leads to inadequate services when working with our homeless population. When we hire more social workers, we lessen the burden and workload for each social worker so they can focus more on their cases. If we want to ensure the safety and well being of homeless individuals and our neighborhoods, we need to increase investment in the people whose job it is to help them off the streets.
Our homeless community is also in areas where they are unable to reach services and have their stuff stolen. To fight this, we need to invest in mobile clinics and public lockers. Mobile clinics would be able to serve the homeless in areas where there aren’t any facilities or homeless services around. It also has the opportunity to help homeless people who are facing a mental illness or at risk of it because it is harder for them to get to a facility.
One of the reasons why many homeless individuals become mentally ill is because of their items and belongings. Often, they would take drugs to stay awake all night to watch over their things, so they don’t get stolen. This problem goes into part two, which is to invest in public lockers for them to store essential items. If we invest in public lockers, it will give the homeless some peace of mind knowing that their things are safe.
In 2017, Senator Josh Green introduced SB 2, which conducted a study into allowing doctors to prescribe Medicaid for rent. A night at an emergency room usually costs $150-$3000. Often, emergency rooms have to take in homeless individuals which ends up costing more Medicaid dollars per night than a month’s rent. Infact, 61% of Hawaii’s $2 billion Medicaid budget is spent on just 3.6% of Hawaii’s Medicaid recipients and there is a huge overlap with these high utilizers and the chronically homeless.
While currently Medicaid money cannot go directly to paying people’s rent, we should be taking greater advantage of CMS’s 1115 waivers and CMMI grants which would allow us to use Medicaid funds for supportive services around housing. Additionally, if we could focus on rapidly and effectively housing our chronically homeless, we could save $300,000,000 in Medicaid spending each year that could then go towards other homeless preventative programs.
Just because someone is homeless does not mean they don’t deserve quality facilities. Also, clean, safe, and quality facilities will not encourage homelessness. I’ve never heard anyone say, “these facilities are beautiful. I’m going to be homeless.” Our homeless population deserves dignity, and that means improving the safety and cleanliness of our shelters. Enhancing safety and sanitation at shelters, it would encourage the homeless community to seek shelter, so they aren’t on the street. Many of our homeless population are families with young kids, and it is dangerous for them to choose to sleep on the street or in a dangerous shelter.
The problem is that there is a divide between the government and our homeless community. This community continues to be marginalized and not taken seriously. These are bold and radial changes, and it’s not going to take one government agency to solve them. We need to bring together leaders from all sectors to the table to think of ways we can address this.